Public acceptance of nature-based solutions: towards sustainable natural hazard risk reduction

Without action, global impacts from natural hazards are expected to increase in frequency and severity due to climate change and concurrent ecological and social crises. Nature-based solutions (NbS) are sustainable approaches to disaster risk reduction (DRR) that provide multiple additional benefits for nature and to a range of stakeholders. NbS contrast with ‘grey’ infrastructure measures, which rely on non-natural materials, generally aim to address a single issue, and have fewer societal co-benefits. NbS are generally conceptualized as ‘green’ measures, although ‘hybrid’ measures (combining green and grey) are also NbS. DRR measures often rely on public and community buy-in for their success, but NbS amplify this reliance with their emphasis on co-creation, -implementation, and -monitoring. Public acceptance is therefore directly linked to the ability of NbS to provide benefits, including DRR. Although NbS research increasingly focuses on barriers to its uptake, there is a lack of research on public acceptance of local residents in NbS ‘host communities’. Instead, it is often taken for granted that current high levels of public acceptance of NbS at European scale will be replicated at local levels and maintained over time. Additionally, there is a lack of past research that compares perceptions of NbS and grey measures, explores a broad range of factors that may influence public acceptance, and determines preferences across the full green-hybrid-grey spectrum. This research, conducted within the Horizon 2020 OPERANDUM project, aims to determine factors that contribute to positive or negative attitudes and behaviours towards NbS for DRR. A systematic literature review was carried out, followed by citizen surveys and focus groups at planned European NbS sites. Surveys were conducted in Scotland (landslides; n=66 respondents), Finland (lake eutrophication; n=204) and Greece (flooding; n=84), followed by in-depth focus groups (n=4) at the Scotland site. Results from the three methods noted above show generally high public acceptance, but also consistently highlight scepticism regarding NbS effectiveness for DRR and uncertainty surrounding the approach as barriers to acceptance. Dozens of factors that can influence acceptance were identified and, despite variation in the strength of factors across study sites, several consistencies emerged. For example, public trust in implementers was important for positive attitudes towards the NbS, while perceptions of place were important for pro-NbS behaviour (i.e., engagement). Cultural ecosystem services, and especially aesthetic value, were highlighted as crucial determinants of acceptance throughout. However, in the Scotland site, the effectiveness of the NbS for reducing risk was paramount and therefore the perceived limitations of NbS drove preferences towards greyer (i.e., more hybrid) measures. This thesis emphasises a need for more focus on the importance of meeting public expectations for risk reduction, providing cultural ecosystem services as co-benefits, centering people-place relations in NbS work, and considering the efficacy and support of hybrid rather than purely green options. Additionally, the Public Acceptance of NbS framework [PA-NbS] is introduced in the review as a starting point for NbS researchers and practitioners to systematise their consideration of public acceptance and how it can be increased. It includes overarching recommendations: provide benefits, increase awareness of benefits, communicate effectively, and promote participation. Each recommendation has four corresponding success criteria which, through the subsequent analyses, are tailored to both the specific contexts of the study sites and for NbS projects globally. Using interdisciplinary concepts and a mixed-methods approach, this research takes a critical perspective with the practice-oriented aim of improving the sustainable success of NbS for DRR. With this, further research is called for to better understand public expectations of NbS, how best to frame NbS and their (co-)benefits to different stakeholders, and how acceptance may change through time based on evidence of NbS performance

A review of public acceptance of nature-based solutions: the ‘why’, ‘when’, and ‘how’ of success for disaster risk reduction measures

Nature-based solutions (NbS) are increasingly recognized as sustainable approaches to address societal challenges. Disaster risk reduction (DRR) has benefited by moving away from purely ‘grey’ infrastructure measures towards NbS. However, this shift also furthers an increasing trend of reliance on public acceptance to plan, implement and manage DRR measures. In this review, we examine how unique NbS characteristics relate to public acceptance through a comparison with grey measures, and we identify influential acceptance factors related to individuals, society, and DRR measures. Based on the review, we introduce the PA-NbS model that highlights the role of risk perception, trust, competing societal interests, and ecosystem services. Efforts to increase acceptance should focus on providing and promoting awareness of benefits combined with effective communication and collaboration. Further research is required to understand interconnections among identified factors and how they can be leveraged for the success and further uptake of NbS

Assessing multi-hazard vulnerability and dynamic coastal flood risk in the Mississippi Delta: The Global Delta Risk Index as a social-ecological systems approach

The tight coupling of the social-ecological system (SES) of the Mississippi Delta calls for balanced natural hazard vulnerability and risk assessments. Most existing assessments have approached these components in isolation. To address this, we apply the Global Delta Risk Index (GDRI) in the Mississippi Delta at high-resolution census tract level. We assess SES spatial patterns of drought, hurricane-force wind, and coastal flood vulnerability and integrate hazard and exposure data for the assessment of coastal flood risk. Moreover, we compare current coastal flood risk to future risk in 2025 based on the modelled effects of flood depth, exposure, and changes in ecosystem area in the context of ongoing efforts under the 2017 Louisiana Coastal Master Plan. Results show that the Master Plan will lead to decreases in risk scores by 2025, but the tracts that are currently the most vulnerable benefit less from risk reduction efforts. Along with our index output, we discuss the need for further advancements in SES methodology and the potential for catastrophic hazard events beyond the model parameters, such as extreme rainfall events and very strong hurricanes. Assessing SES risk components can lead to more targeted policy recommendations, demonstrated by the need for Master Plan projects to consider their unequal spatial effects on vulnerability and risk reduction

Context matters: co-creating nature-based solutions in rural living labs

The use of Nature-based Solutions (NBS), designed and implemented with participatory approaches, is rapidly increasing. Much use is being made of the Living Lab (LL) concept to co-create innovative NBS with stakeholders in a certain societal and environmental, real-life context. Most of the current research revolves around urban LLs, thus overlooking specificities of rural areas. Furthermore, the influence of the context itself on co-creation processes is insufficiently recognised, leaving challenges associated with co-creation such as stakeholder engagement unresolved. By exploring the co-creation processes in the LLs of the OPERANDUM project, this study identifies eighteen contextual factors shaping the co-creation processes of NBS within rural territories and provides associated recommendations. In addition, based on lessons learnt in the OPERANDUM project, we discuss the value of a relational place-based approach in LLs, suggesting that the co-creation process should be approached as a dynamic confluence of many interconnected contextual factors. We conclude that acknowledging the interconnections in co-creation in the real-life context of rural territories may increase the success and impact of the LL approach, and ultimately, the benefits of NBS

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets. FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. FUNDING: Bill & Melinda Gates Foundation

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms